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Late Sequelae of Thoracic Injury

Sebastien Gilbert, Andrew B. Peitzman, Peter Ferson
Late Sequelae of Thoracic Injury is a topic covered in the Pearson's General Thoracic.

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Key Points

  • Because of associated injuries, delays often occur in the management of traumatic chest injuries.
  • Sequelae of hemothorax are the most common.
  • In operative candidates, surgical resection should be the preferred treatment option for benign airway strictures.
  • Sequelae result from chest wall injury, tracheobronchial injury, or hemothorax

In spite of well-planned management protocols for patients with blunt and penetrating thoracic trauma, delays in the treatment of chest injuries often occur. Prioritization of the treatment of more life-threatening injuries and initial misdiagnosis are common reasons for such delays. Although the initial therapy may palliate such injuries, this temporizing treatment may be insufficient to prevent subsequent sequelae.[1],[2] Thoracic injuries may also result in significant long-term impairment. Quality-of-life scores remain persistently lower than in the general population up to 18 months after major thoracic trauma.[1] The proper management of thoracic injury manifesting in a delayed fashion requires an understanding of the initial mechanism of injury, the development of symptoms and their time frame, the natural history of the injury when left untreated, and the options for therapy. Even when the best available treatment is promptly instituted, long-term sequelae may occur and cause significant problems. Awareness of these issues and judicious surgical intervention should facilitate appropriate therapy, prevent long-term sequelae, and, it is hoped, preserve quality of life.

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Key Points

  • Because of associated injuries, delays often occur in the management of traumatic chest injuries.
  • Sequelae of hemothorax are the most common.
  • In operative candidates, surgical resection should be the preferred treatment option for benign airway strictures.
  • Sequelae result from chest wall injury, tracheobronchial injury, or hemothorax

In spite of well-planned management protocols for patients with blunt and penetrating thoracic trauma, delays in the treatment of chest injuries often occur. Prioritization of the treatment of more life-threatening injuries and initial misdiagnosis are common reasons for such delays. Although the initial therapy may palliate such injuries, this temporizing treatment may be insufficient to prevent subsequent sequelae.[1],[2] Thoracic injuries may also result in significant long-term impairment. Quality-of-life scores remain persistently lower than in the general population up to 18 months after major thoracic trauma.[1] The proper management of thoracic injury manifesting in a delayed fashion requires an understanding of the initial mechanism of injury, the development of symptoms and their time frame, the natural history of the injury when left untreated, and the options for therapy. Even when the best available treatment is promptly instituted, long-term sequelae may occur and cause significant problems. Awareness of these issues and judicious surgical intervention should facilitate appropriate therapy, prevent long-term sequelae, and, it is hoped, preserve quality of life.

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Last updated: April 8, 2020